Form CMS-1500
Form CMS-1500 is the universal claim form that is used by non-institutional healthcare providers when submitting paper claims for reimbursement. Form CMS-1500 contains all the basic information that is needed to submit an accurate claim. This includes fields for the patient’s demographic information, insurance information, and boxes in which you provide medical codes and corresponding dates of service. Certain boxes are used exclusively for Medicare or Medicaid, or both.